Text: S.811 — 111th Congress (2009-2010)All Information (Except Text)

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Introduced in Senate (04/02/2009)

1st Session
S. 811

To amend the Public Health Service Act to promote mental and behavioral health services for underserved populations.


April 2, 2009

Mr. Inouye introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions


To amend the Public Health Service Act to promote mental and behavioral health services for underserved populations.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. Short title.

This Act may be cited as the “Graduate Psychology Education Act of 2009”.

SEC. 2. Findings.

Congress finds that—

(1) the Institute of Medicine issued a 2006 report entitled “Improving the Quality of Health Care for Mental and Substance Abuse Conditions”, which called for efforts to increase the mental and behavioral health care workforce in the United States, and to assure competency of that workforce;

(2) the “Action Plan for Behavioral Health Workforce Development”, commissioned in 2007 by the Substance Abuse and Mental Health Services Administration, reported an insufficient supply of trained professionals available to provide mental and behavioral health services to older adults, and predicted that such shortage would become more dire as the aging population grows and the demand for specialized mental and behavioral health services increases;

(3) the Bureau of Labor Statistics projects a need for approximately 70,000 more doctoral level health service psychologists, including clinical psychologists, counselors, and school psychologists, in the United States by 2016;

(4) the Department of Defense Task Force on Mental Health reported in 2007 that—

(A) the Nation faces a great need for adequately trained mental health professionals, both civilian and in the Armed Forces;

(B) nearly 40 percent of soldiers and half of National Guard members report psychological “symptoms” and these problems are “daunting and growing”; and

(C) increasingly, National Guard members, reservists, and even active duty members of the Armed Forces who are stationed far from health care installations of the Armed Forces, as well as the families of such individuals, are more likely to seek care in civilian settings, thus increasing the demand for mental health services in those communities;

(5) according to a report of the Health Resources and Services Administration in September 2008, there are 3,059 mental health professional shortage areas in rural and urban areas of the United States, in which 77,000,000 people live, and, based on the Administration's population to practitioner ratio of 10,000:1, an additional 5,145 mental health providers are required to meet the immediate needs of the mental health professional shortage areas;

(6) the Annapolis Coalition Report, commissioned in 2007 by the Substance Abuse and Mental Health Services Administration—

(A) found substantial needs to increase the mental and behavioral health workforce of the future and to broaden the racial and cultural diversity of that workforce; and

(B) identified a pending retirement of more than half of the clinically trained mental and behavioral health professionals in the United States, along with a serious shortage of providers in rural areas, and urged a national focus on—

(i) addressing the needs of underserved persons dealing with chronic illnesses;

(ii) treating young people with mental disorders; and

(iii) working with young people to help prevent risk-taking behaviors, including smoking, substance abuse, violence, unsafe sex, and actions that might cause vehicular accidents;

(7) according to multiple reports of the Surgeon General on the mental health of children and older adults—

(A) there is an urgent need for a well-trained mental and behavioral health workforce to treat the increase in depression and suicide;

(B) 2 out of every 100 children and adolescents have major depression, and 20 percent of older adults suffer from depression;

(C) depression is a condition commonly associated with suicide and older adults are disproportionately likely to die by suicide; and

(D) in general, suicide rates for adults and children are higher in rural communities than in urban communities;

(8) in 2007, the President’s Commission on Care For America’s Returning Wounded Warriors (the “Dole-Shalala Commission”)—

(A) recommended that the Department of Defense aggressively address the acute shortage of mental health clinicians in the Armed Forces;

(B) recognized that the health care system in the United States is certain to experience increased strain for years to come as active duty service members re-enter civilian society in local communities and turn to mental health care professionals skilled in treating such combat stress disorders and their effects on families, which is especially significant due to the expected long-term demand that may arise from chronic or delayed-onset symptoms of post-traumatic stress disorder;

(C) reported that the Armed Forces’s new efforts to prevent mental health problems and identify symptoms more quickly have severely stretched the already thin mental health program staff; and

(D) reported that hospitals located in geographically isolated or less desirable areas report great difficulty recruiting civilian staff; and

(9) the determinants of human health include a complex array of biological, environmental, and social factors, an individual’s behavior and coping resources, and an individual's access to health care; although biologic interventions, including medications and immunizations, often are considered the hallmark of medical practice, the role of behavior and psychosocial components has received increasing attention, and, because approximately half of mortality in the United States is linked to behavior, behavioral science and practice are fundamental to addressing societal needs.

SEC. 3. Promoting education and training of psychologists to provide mental and behavioral health services to underserved populations.

Part E of title VII of the Public Health Service Act (42 U.S.C. 294n et seq.) is amended by adding at the end the following:

“subpart 3Mental and behavioral health care workforce

“SEC. 775. Program for graduate education and training in psychology.

“(a) In general.—The Secretary may award grants, cooperative agreements, and contracts to accredited doctoral, internship, and residency programs in psychology for the development and implementation of programs to provide interdisciplinary training in integrated health care settings to students in doctoral psychology programs, including interns and residents in such programs. Any training funded by such grants, cooperative agreements, or contracts shall focus on the needs of underserved populations.

“(b) Eligibility.—To be eligible to receive an award under this section an entity shall—

“(1) provide training at or through an accredited doctoral program in psychology, including an internship or residency program; and

“(2) prepare and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.

“(c) Evaluation of programs.—The Secretary shall evaluate any program implemented through an award under this section in order to determine the effect of such program on increasing the number of psychologists who provide mental and behavioral health services to underserved populations.

“(d) Definitions.—For purposes of this section—

“(1) the term ‘underserved population’ means individuals, especially older adults, children, chronically ill individuals, victims of abuse or trauma, and victims of combat- or war-related stress disorders, including post-traumatic stress disorder and traumatic brain injury, and their families, living in an urban or rural area that has a shortage of mental or behavioral health services; and

“(2) the term ‘interdisciplinary training’ means training for graduate psychology students with 1 or more of the other health professions, including medicine, nursing, dentistry, and pharmacy.

“(e) Authorization of appropriations.—To carry out this section, there is authorized to be appropriated $10,000,000 for fiscal year 2010, $12,000,000 for fiscal year 2011, $14,000,000 for fiscal year 2012, $16,000,000 for fiscal year 2013, and $18,000,000 for fiscal year 2014.”.